Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.

Saturday, October 22, 2016

The Heated Battle Over Involuntary Committment

So often I write blog posts about topics I read about in the paper. I take a few quotes and expand upon them. Today I want to look at book review by Dr. Damon Tweedy, a psychiatrist at Duke University and author of Black Man in a White Coat: A Doctor's Reflection on Race and Medicine. Only this is a little different. Dr. Tweedy is reviewing a book that We wrote! And a fine job he did, if I do say so myself.

Here, they explore forced psychiatric care, perhaps the most polarizing
aspect of a controversial profession. The result is a highly informative
and surprisingly balanced book that should be read by anyone with a
personal or professional stake in how the mental health system provides
care to those with chronic severe illnesses and those in acute crisis.

Miller and Hanson take us on a journey across America, where we witness
significant variability in how states approach the issue of forced care.
In some states, patients must be deemed imminently dangerous to
themselves or others (i.e. high risk for suicide or homicide) for forced
treatment, while in other states an inability to provide for basic
needs due to mental illness is sufficient. The process of commitment
also differs. California, for instance, does not require a formal
psychiatric evaluation before patients can be involuntarily admitted to a
psychiatric hospital, while in Maryland an evaluation must be done
before admission and requires the input of two physicians or
psychologists. Until recently, doctors in Virginia could not use the
input of family members in assessing a person’s potential dangerousness. And finally:

Although “Committed” explores a complex subject, Miller and Hanson make a
great effort to humanize this discussion. In each section, they
introduce us to individuals — patients, family members, advocates,
lawmakers, emergency-room doctors, psychiatrists, police officers and
judges — involved in some aspect of forced treatment.Thank you, Dr. Tweedy!